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Improving Corridor Compliance Through
Inventory Analytics
Session 173, February 13, 2019
Jillian S. Waller, M.H.A., Health Systems Engineer,
Management Engineering & Internal Consulting, Mayo Clinic
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Jillian S. Waller, M.H.A. has no real or apparent conflicts
of interest to report.
Conflict of Interest
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• Background & Project Goal
• Methodology
• Findings
• Recommendations
• Implementation
• Post-Implementation
• Items for Further Study
• Lessons Learned
• Q&A
Agenda
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• Discuss the challenges of eliminating corridor clutter in space-
constrained facilities
• Demonstrate how equipment demand can be measured and
analyzed using basic statistical methods
• Describe how a sustainable offsite inventory strategy can be
developed in a manner that works for all stakeholders
• Identify the role that institutional norms and individual behaviors
play in managing equipment inventory in a sustainable way, with
emphasis on change management
Learning Objectives
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• Hospital hallways cluttered with unused patient care equipment
(e.g. beds, IV poles, recliners, cots)
• Eye sore
• Potential hazards
• Potential accreditation compliance issues
• “Aisles, corridors, and ramps required for exit access in a
hospital… shall not be less than 8 feet in clear and
unobstructed width.” (Joint Commission Comprehensive
Accreditation Manuals, Life Safety Code)
Background
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• Implications for staff
• Motion waste
• Difficulty locating items
• Implications for equipment itself
• Damage, loss, contamination
• Space constraints
• Available space is valuable
• Storage is dead space
• Carrying / holding costs
Background
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Identify a storage solution to eliminate hallway clutter.
Goal
Do not use additional space on the downtown campuses.
Use the Methodist Campus as a test case.
Parameters
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Understanding demand for equipment
• Analysis of equipment transport request data
– Looked at 12 months of historical data
• 5,961 delivery requests
– Significant data prep required
• Free-text fields
Methodology
“Can you please
send an ortho bed
to EI_05_04?
Thanks much!!”
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Understanding demand for equipment
• Analysis of equipment transport request data
– Count of requests by date
– Mean number of requests per day
– Mean request completion duration
Methodology
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Understanding the system
• Stakeholder interviews
– Nursing
– Environmental Services
• Direct observation
– Inventory
Methodology
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• Pareto principle
– The five most requested items accounted for 80% of all
delivery requests that year
• Cots, beds, recliners, bed extenders, tray tables
• On average, requests were completed in 2 hr 10 min
• Using 2000 square feet of onsite storage space
– Not including what we see in hallways and elevator banks!
Findings
Total Number of Items Requested
Average Request Completion Duration by Item
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• Much of the equipment demand could be predicted
– Scheduled cases (e.g. ortho, gyn surgery, transplant,
plastics, urology, colorectal surgery, etc.)
• Stockpiling or “hoarding” of equipment on floors largely due to lack
of trust in the system
Findings
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• Develop an inventory solution utilizing both offsite warehouse
space and limited onsite space
– Offsite
• Identify warehouse space
• Items in excess of true onsite need would move offsite
• Utilize just-in-time delivery principles to get items from
warehouse to downtown as needed
Recommendations
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• Develop an inventory solution utilizing both offsite warehouse
space and limited onsite space
– Onsite
• Organize space using 5S principles (Sort, Set in Order,
Shine, Standardize, Sustain)
• Most requested items should be most accessible
• Clearly labeled reorder point
Recommendations
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Determining appropriate stocking levels
• Analysis of equipment transport request data, by item
– Slightly skewed distributions
• Performed normalization transformation
– Developed a 95% tolerance interval
– Calculated safety stock and reorder point*
Implementation Strategy
SS = z
α
× E(L)σ
2
D
+ (E(D))
2
σ
2
L
ROP = E(L) · E(D) + SS
* Ballou, R. H. (2011). Business logistics/supply chain management planning, organizing, and controlling the supply chain (5th ed.).
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Sample table calculations for five most requested items.
Implementation Strategy
Item
Mean
UTL
SS
Proposed
Stock
Current
Stock
Sq. ft.
per Item
Onsite Space
Need
Cot
5.3
8.7
2
11
15
2.9
31.9
Bed
2.7
5.2
1
7
28
23.7
165.9
Recliner
2.5
4.5
1
6
7
6.7
40.2
Bed
extender
1.4
2.8
1
4
4
5.3
21.2
Used
●●●
Number of Items Requested by Date - Beds
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• Identified a Mayo-owned warehouse
– Existing delivery schedule with four daily deliveries
– Excess items moved over
• Cleaned up onsite storage area
– Clearly labeled reorder point
– Items organized by frequency of use
Implementation Strategy
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• Change management efforts in partnership with Nursing
– Encourage adherence to the strategy
• Returning items to the designated storage spaces
• Changing behavioral norms
– Ensure accountability for equipment
• Pre-order for scheduled cases
• Assess inventory on the floor daily
Change Management
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• No reported headaches or known issues
• Nearly 1200 sq. ft. of valuable real estate saved
– Gained additional space for patient care
• Increased compliance with Joint Commission requirements
• Continuously monitoring the number of requests
– We anticipate increased equipment demand with our
increasing volumes
Post-Implementation Update
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• Exploring scalability at our St. Mary’s campus
– 24/7 Emergency Department
– Much larger facility
• Technical infrastructure improvements
– Buy new software, or alter existing one
– Automatically trigger the warehouse at the reorder point
• Integration with EHR
– Prompt at the creation of a transfer / discharge
Items for Further Study
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• Give ample notice to all parties
• Shared governance can create unexpected complications
– Nursing Support Services “owns” the equipment
– Environmental Services fulfills the requests
– Committees allocate and designate space
• Consider feasibility– 24 hour demand requires 24 hour supply
Lessons Learned
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Jillian S. Waller, M.H.A.
Waller.Jillian@mayo.edu
www.linkedin.com/in/jillianwaller/
Your feedback in the online session evaluation is greatly
appreciated. Thank you!
Questions